结合生理-心理-行为干预的多元化康复在老年腰椎间盘突出症患者术后康复中的应用研究

Research on application of diversified rehabilitation exercise combined with physiological-psychological-behavioral intervention in postoperative rehabilitation of elderly patients with lumbar intervertebral disc protrusion

中文关键词: 老年  腰椎间盘突出症  术后康复  腰椎功能  疼痛程度

英文关键词: elderly  lumbar disc herniation  postoperative rehabilitation  lumbar spine function  pain level

中文摘要:

      目的 观察结合生理-心理-行为干预的多元化康复锻炼对老年腰椎间盘突出症(LDH)患者术后康复的效果.方法 回顾性分析2022年1月—2023年12月在南京医科大学附属淮安市第一人民医院接受治疗的210例老年LDH患者的临床资料,依据患者术后不同的干预措施分为观察组与对照组,每组105例.对照组患者行常规护理干预,观察组采用常规护理干预联合多元化康复锻炼治疗.记录患者术后康复效果,采用日本骨科协会腰椎功能评估量表(JOA)评估患者腰椎功能,麦吉尔疼痛问卷(MPQ)评估患者疼痛情况,等速测试技术对患者腰背伸肌群生物力学指标进行检测.结果 观察组患者优良率高于对照组(90.48％vs 75.24％,P＜0.05).干预后,2组患者膀胱功能、主观症状、日常活动受限程度和临床症状评分高于同组干预前,且观察组高于对照组(P＜0.05);2组患者视觉模拟评分、疼痛情绪评分、疼痛感觉评分和疼痛总评分均低于同组干预前,且观察组低于对照组(P＜0.05).干预后观察组患者腰背屈伸比低于对照组,平均功率和峰力矩高于对照组(P＜0.05).结论 结合生理-心理-行为干预的多元化康复锻炼可提高老年腰椎间盘突出症患者术后康复效果,改善患者术后腰椎功能和腰背伸肌群生物力学指标,降低患者术后疼痛感.

英文摘要:

      Objective To observe the effects of diversified rehabilitation exercise combined with physiological-psycho-logical-behavioral intervention on the postoperative rehabilitation of elderly patients with lumbar intervertebral disc protrusion(LDH).Methods A retrospective analysis was conducted on the clinical data of 210 elderly patients treated in Huai'an First People's Hospital Affiliated to Nanjing Medical University from January 2022 to December 2023.According to different postop-erative intervention measures,they were divided into observation group and control group,with 105 cases in each group.The control group received routine nursing intervention,and the observation group received diversified rehabilitation exercise on the basis of the control group.The postoperative rehabilitation effect of the patients was recorded.The lumbar function was evalua-ted by the Japanese Orthopaedic Association Lumbar Function Assessment Scale(JOA),the pain condition was evaluated by the McGill Pain Questionnaire(MPQ),and the biomechanical indicators of the lumbar and dorsal extensor muscle groups were detected by the isokinetic test technique.Results The excellent and good rate in the observation group was higher than that in the control group(90.48％vs75.24％,P＜0.05).After the intervention,the bladder function,subjective symptoms,degree of daily activity limitation and clinical symptom scores of the two groups were higher than those of the same group before the in-tervention,and the observation group was higher than the control group(P＜0.05).The visual analogue scale score,pain emotion score,pain sensation score and total pain score of the two groups were all lower than those of the same group before the intervention,and the observation group was lower than the control group(P＜0.05).After the intervention,the lumbar and dorsal flexion and extension ratio in the observation group was lower than that in the control group,and the average power and peak torque were higher than those in the control group(P＜0.05).Conclusion Diversified rehabilitation exercises combined with physiological-psychological-behavioral interventions can improve the postoperative rehabilitation effect of elderly LDH pa-tients,improve the postoperative lumbar function and biomechanical indicators of the lumbar and dorsal extensor muscle groups,and reduce the postoperative pain.